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In a wide-ranging scheme, AbbVie (ABBV) used a combination of old-fashioned kickbacks to doctors and a stealthy network of nurses to illegally boost prescriptions of its best-selling Humira treatment, according to a lawsuit filed on Tuesday by the California insurance commissioner.

Over a five-year period, the drug maker offered physicians a familiar menu of tempting items, from cash, meals and drinks, to gifts and trips, along with patient referrals, in hopes they would write more prescriptions for its Humira rheumatoid arthritis treatment, a $12.3 billion seller in the U.S. last year.

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However, AbbVie also engaged in an allegedly more nefarious practice in which registered nurses were hired to act as “ambassadors” to visit patients at home and help with administering the drug, but instead were used to ensure that prescriptions were continually refilled, the lawsuit stated.

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